Royal College of Surgeons in Ireland
Efficacy and safety of trastuzumab deruxtecan in breast cancer....pdf (1.83 MB)

Efficacy and safety of trastuzumab deruxtecan in breast cancer: a systematic review and meta-analysis

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Version 2 2023-12-21, 15:50
Version 1 2023-11-01, 14:49
journal contribution
posted on 2023-11-01, 14:49 authored by Gavin DowlingGavin Dowling, Gordon DalyGordon Daly, Stephen KeelanStephen Keelan, Fiona BolandFiona Boland, Sinead ToomeySinead Toomey, Arnold HillArnold Hill, Bryan HennessyBryan Hennessy

Trastuzumab deruxtecan (T-DXd) is a novel antibody-drug-conjugate (ADC), primarily used in the treatment of HER2-positive breast cancer. This study aimed to conduct a systematic review to evaluate the efficacy and safety of T-DXd in treating breast cancer, based on clinical trials. A systematic search of the literature was conducted to identify clinical trials investigating the efficacy and safety of T-DXd in breast cancer. Clinical trials of any phase were included. Outcome measures were any adverse events and survival. Meta-analysis was conducted where possible. Pooled prevalence for each adverse event of any grade and grade 3 or greater were estimated. Progression-free survival (PFS), overall survival (OS) and objective response rates (ORRs) were also reported to evaluate the efficacy of T-DXd in breast cancer. A total of 1593 patients from 6 clinical trials were included. Common adverse events of any grade were nausea, anemia, neutropenia, vomiting, fatigue, constipation and diarrhea, occurring in greater than 30% of cases. In terms of adverse events of grade 3 or more, only anemia and neutropenia occurred at a relatively high rate. Median PFS ranged from 11.1 to 22.1 months. There was evidence of a benefit of T-DXd compared to controls in terms of both PFS (OR: 0.38; 95% CI: 0.32, 0.45) and OS (OR: 0.61; 95% CI: 0.48, 0.78). ORRs ranged from 37% to 79.9%. The present systematic review shows evidence that T-DXd is a safe and effective agent in the treatment of breast cancer based on currently available data. The most common adverse events affected the blood, lymphatic and gastrointestinal systems. Interstitial lung disease (ILD) is a notable and potentially serious adverse event. 


RCSI-Bon Secours Hospital Dublin StAR MD programme 2022.



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Published Citation

Dowling GP. et al. Efficacy and safety of trastuzumab deruxtecan in breast cancer: a systematic review and meta-analysis. Clin Breast Cancer. 2023;23(8):847-855.e2.

Publication Date

11 September 2023

PubMed ID



  • Beaumont Hospital
  • Data Science Centre
  • Molecular Medicine
  • Surgery




  • Published Version (Version of Record)